영아기 폐결핵의 임상양상에 대한 고찰 = Clinical Features , Prognosis and Treatment of Pulmonary Tuberculosis in Infants

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Despite many studies of tuberculosis among children in Korea series of infants with primary pulmonary tuberculosis have rarely been reported. This study was undertaken to describe the epidemiology, clinical and radiologic manifestation, and response to therapy in primary pulmonary tuberculosis with abnormal chest radiography. This study was performed to be helpful in early diagnosis and treatment of the infant with pulmonary tuberculosis. This study reviewed 27 infants with primary pulmonary tuberculosis who had been admitted to Han yang University Hospital during the 14 year period from January 1980 to December 1993 retrospectively about history, symptomatology, tuberculin test, BCG vaccination, treatment and follow-up. The results are as following, 1) Age and sex incidence of infants with primary pulmonary tuberculosis (4 months to 12 months of age) showed that male predominated in a proportion of 1.7:1, the incidence of family history was 67% (18 cases). 2) The chief complaints on admission were cough in 24 patients (89%), fever 14 patients (51.9%), asymptomatic in 3 patients (11%), seizure in 1 patients (3.7%). 3) Of the 14 infants who had abnormal lung sound in infantile pulmonary tuberculosis, crackling sounds was auscultated in 10 cases, wheezing was 6, decreased breathing sound was 4, the order is both, left, and then right lung field. 4) Twenty infants (74%) were vaccinated BCG. Among them 1 cases with negative tuberculin test, 6 case with strong positive tuberculin test. All of non-vaccinated are strong positive. 5) The patient had treated with INH+EMB, INH+HFP+SM, INH+RFP in sequence before 1985 but more frequently used INH+BFP since 1985 and then INH+RFP recently. 6) Among 18 patients (66.7%) who have been follow-up, almostly improved clinically and radiologically except only 1 case partial improvement. Treatment was we11 tolerated: one patient developed hepatotoxicity and hyperuricemia due to INH and SM probably but spontaneous recovered. In conclusion, most infants with tuberculosis are symptomatic at the time of diagnosis, contact investigation of the household, tuberculin test and chest radiologic findings needed to establish the diagnosis and guide therapy in the infants may be obtained despite BCG vaccination.